With the present health manpower shortage and the unequal distribution of health resources, there is need to demonstrate effective and economical means of providing more accessible health services. Our experiences in rural Mississippi and in our nurse-midwifery education program have shown in a limited fashion that a maternal-infant health care team with the nurse-midwife as the central figure is a highly effective means of delivering maternal and infant health care. The purpose of this prospective, longitudinal study is to demonstrate and evaluate the cost, utilization and effectiveness of health care provided to low-income patients by MCH care team based at the University Medical Center and in outreach services in urban and rural communities. Comparisons of health outcomes, quality of management of care, delivery patterns and procedures will be demonstrated using the following approach: a. an experimental study at a University teaching hospital; b. an experimental study in MATERNAL-INFANT CARE project; c. vital data analyses of a nurse-midwifery service in a rural county/private community hospital without house-staff or obstetricians; d. a cost-effectiveness study comparing nurse-midwifery care in several settings to traditional modes of maternal-infant health care delivery.